{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T17:10:47Z","timestamp":1771261847497,"version":"3.50.1"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,18]],"date-time":"2024-02-18T00:00:00Z","timestamp":1708214400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,18]],"date-time":"2024-02-18T00:00:00Z","timestamp":1708214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Intracardiac thrombus and vascular air embolism represent rare complications in the context of orthotopic liver transplantation. While isolated reports exist for intracardiac thrombus and vascular air embolism during orthotopic liver transplantation, this report presents the first documentation of their simultaneous occurrence in this surgical setting.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>This case report outlines the clinical course of a 60-year-old white female patient with end-stage liver disease complicated by portal hypertension, ascites, and hepatocellular carcinoma. The patient underwent orthotopic liver transplantation and encountered concurrent intraoperative complications involving intracardiac thrombus and vascular air embolism. Transesophageal echocardiography revealed the presence of air in the left ventricle and a thrombus in the right atrium and ventricle. Successful management ensued, incorporating hemodynamic support, anticoagulation, and thrombolytic therapy, culminating in the patient\u2019s discharge after a week.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This report highlights the potential for simultaneous intraoperative complications during orthotopic liver transplantation, manifesting at any phase of the surgery. It underscores the critical importance of vigilant monitoring throughout orthotopic liver transplantation to promptly identify and effectively address these rare yet potentially catastrophic complications.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-024-04376-8","type":"journal-article","created":{"date-parts":[[2024,2,18]],"date-time":"2024-02-18T03:28:36Z","timestamp":1708226916000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Intraoperative vascular air embolism and intracardiac thrombosis complicating liver transplantation: a case report"],"prefix":"10.1186","volume":"18","author":[{"given":"Jorge","family":"Sinclair De Fr\u00edas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Olivero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary","family":"Fleissner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Burns","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Chadha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Moreno Franco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,2,18]]},"reference":[{"issue":"6","key":"4376_CR1","doi-asserted-by":"publisher","first-page":"878","DOI":"10.1182\/blood-2010-02-261891","volume":"116","author":"T Lisman","year":"2010","unstructured":"Lisman T, Porte RJ. Rebalanced hemostasis in patients with liver disease: evidence and clinical consequences. Blood. 2010;116(6):878\u201385. https:\/\/doi.org\/10.1182\/blood-2010-02-261891.","journal-title":"Blood"},{"issue":"11","key":"4376_CR2","doi-asserted-by":"publisher","first-page":"1682","DOI":"10.1002\/lt.25498","volume":"25","author":"MK Groose","year":"2019","unstructured":"Groose MK, Aldred BN, Mezrich JD, Hammel LL. Risk factors for intracardiac thrombus during liver transplantation. Liver Transpl. 2019;25(11):1682\u20139. https:\/\/doi.org\/10.1002\/lt.25498.","journal-title":"Liver Transpl"},{"issue":"10","key":"4376_CR3","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.1002\/lt.24161","volume":"21","author":"P Peiris","year":"2015","unstructured":"Peiris P, Pai SL, Aniskevich S 3rd, et\u00a0al. Intracardiac thrombosis during liver transplant: a 17-year single-institution study. Liver Transpl. 2015;21(10):1280\u20135. https:\/\/doi.org\/10.1002\/lt.24161.","journal-title":"Liver Transpl"},{"issue":"2","key":"4376_CR4","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1111\/j.1538-7836.2007.02831.x","volume":"6","author":"N Warnaar","year":"2008","unstructured":"Warnaar N, Molenaar IQ, Colquhoun SD, et\u00a0al. Intraoperative pulmonary embolism and intracardiac thrombosis complicating liver transplantation: a systematic review. J Thromb Haemost. 2008;6(2):297\u2013302. https:\/\/doi.org\/10.1111\/j.1538-7836.2007.02831.x.","journal-title":"J Thromb Haemost"},{"issue":"1","key":"4376_CR5","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1053\/j.jvca.2015.09.009","volume":"30","author":"SK Shillcutt","year":"2016","unstructured":"Shillcutt SK, Ringenberg KJ, Chacon MM, et\u00a0al. Liver transplantation: intraoperative transesophageal echocardiography findings and relationship to major postoperative adverse cardiac events. J Cardiothorac Vasc Anesth. 2016;30(1):107\u201314. https:\/\/doi.org\/10.1053\/j.jvca.2015.09.009.","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"4","key":"4376_CR6","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1016\/0002-9149(92)91200-n","volume":"70","author":"WE Hopkins","year":"1992","unstructured":"Hopkins WE, Waggoner AD, Barzilai B. Frequency and significance of intrapulmonary right-to-left shunting in end-stage hepatic disease. Am J Cardiol. 1992;70(4):516\u20139. https:\/\/doi.org\/10.1016\/0002-9149(92)91200-n.","journal-title":"Am J Cardiol"},{"issue":"1","key":"4376_CR7","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14504","volume":"36","author":"C Crouch","year":"2022","unstructured":"Crouch C, Sakai T, Aniskevich S, et\u00a0al. Adult liver transplant anesthesiology practice patterns and resource utilization in the United States: survey results from the society for the advancement of transplant anesthesia. Clin Transplant. 2022;36(1): e14504. https:\/\/doi.org\/10.1111\/ctr.14504.","journal-title":"Clin Transplant"},{"issue":"10","key":"4376_CR8","doi-asserted-by":"publisher","first-page":"1603","DOI":"10.1002\/lt.26489","volume":"28","author":"E Fagelman","year":"2022","unstructured":"Fagelman E, Wang R, Tomlinson A, et\u00a0al. Intraoperative intracardiac thrombus in liver transplantation: a 9-year retrospective review focusing on treatment and outcomes. Liver Transpl. 2022;28(10):1603\u201317. https:\/\/doi.org\/10.1002\/lt.26489.","journal-title":"Liver Transpl"},{"key":"4376_CR9","doi-asserted-by":"publisher","first-page":"6268370","DOI":"10.1155\/2016\/6268370","volume":"2016","author":"C Protin","year":"2016","unstructured":"Protin C, Bezinover D, Kadry Z, Verbeek T. Emergent management of intracardiac thrombosis during liver transplantation. Case Rep Transplant. 2016;2016:6268370. https:\/\/doi.org\/10.1155\/2016\/6268370.","journal-title":"Case Rep Transplant"},{"issue":"2","key":"4376_CR10","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1213\/ANE.0b013e31820472d4","volume":"112","author":"JD Boone","year":"2011","unstructured":"Boone JD, Sherwani SS, Herborn JC, Patel KM, De Wolf AM. The successful use of low-dose recombinant tissue plasminogen activator for treatment of intracardiac\/pulmonary thrombosis during liver transplantation. Anesth Analg. 2011;112(2):319\u201321. https:\/\/doi.org\/10.1213\/ANE.0b013e31820472d4.","journal-title":"Anesth Analg"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04376-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-024-04376-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04376-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,18]],"date-time":"2024-02-18T03:28:38Z","timestamp":1708226918000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-024-04376-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,18]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4376"],"URL":"https:\/\/doi.org\/10.1186\/s13256-024-04376-8","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,18]]},"assertion":[{"value":"16 May 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate."}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declared no potential conflicts of interest with respect to the research, authorship, and\/or publication of this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"59"}}